My mom has lived with us for a few years, and has been fairly independent all but financially. But now i am noticing lapses in her self care (like bathing or keeping her room clean) but she's still active and independent in many ways- still drives, etc. she manages her own money but is spending on lots of frivolous things. I am concerned about her judgement and all but when shes still somewhat independent it makes it difficult to step in and say something. Meanwhile my husband is getting frustrated with my reluctance to speak up. I need someone to talk to to help me decide when/how to start intervening. Any advice is welcome. I just dont want to take away her independence unless/until absolutely necessary, but i am also concerned about her ability to care for herself, because she's rarely bathing, her room is starting to smell and is piled with clutter. She doesn't vacuum until i am about to go in there and do it myself, and i can tell she's depressed and i'm worried about her medical care. Anyway- advice is appreciated
I think the problem with you and hubby is going deeper here and needs a deeper discussion between the two of you. About the changes you are both seeing. About their dangers. About what you can/cannot do are willing/unwilling to do, about how long it can go on, about next steps when it cannot go on, about your own rights to a good time in your own retirement years, and etc. Just all of it.
I am so sorry. It does come to this. You know, I am sure, and have stood witness to the trajectory. I wish you the best.
I just want to clarify that YOU will not be taking away Mom’s “ independence” .
Her age related decline will be doing that .
If your Mom ever claims , as my father in law did constantly , that his “ independence was being taken away “…..
You answer with, “ I’m sorry Mom , your age is taking away your independence , not me . I did not make you old , and I can not fix old “.
Yet, she's still allowed to drive a car and have full access to her finances.
Think about that for a second.
Get her to her doctor, but before the appointment speak to him privately and explain what's going on now. He can get her license revoked and help you get set up with services like homecare, social work, and even placement in AL if it comes to that.
Plus a lack of judgement often goes hand in hand with dementia too.
Time to make an appointment with moms doctor to have her evaluated, and put on an anti-depressant.
And I would either notify her doctor ahead of time via the patient portal to let them know exactly what is going on with her, or at the very least hand a note to his nurse prior to going back to exam room for your mom to be seen with your concerns.
Your mom is obviously starting to decline, and it's best now to discuss with your husband what exactly that may mean for the future of your moms care, and perhaps even looking into other living options for her such as moving into an assisted living facility with a memory care unit attached for if and when she may need it if she gets diagnosed with dementia.
And please don't forget that your husband and marriage MUST come before your mom.
Then I scheduled her annual wellness check (free through Medicare). I sent a note to her doc through her portal to request a cognitive exam because of the concerns I was having with her memory and behaviors). I needed a formal diagnosis on the clinic letterhead signed by her doctor in order to start managing a few of her financial assets.
I went into the appointment with her and sat behind her so if she wasn't honest in answering the doc's questions I'd be moving my head yes or no. Then my Mom bragged to her doctor that she was still driving. Her wise doctor (also a senior woman) the ordered a virtual driving assessment through our OT dept. Long story short I convinced my Mom to go to "prove" she was still a good driver to everyone. But she failed with flying colors. The OT tech had to break the news to my Mom telling her she was a "high risk" driver, then her doc had to report the results to the and the Dept of Public Safety, who sent out a letter cancelling her license.
That's the driving piece.
I'm hoping you are her PoA. If not, please find a way to get her to assign you BEFORE she gets a diagnosis of impairment. If she's reluctant, you can make an appointment with a certified elder law attorney (for your Mom) but tell her it's for you to assign a PoA. Then when you're at the appointment with her, make sure you ask the attorney what happens when someone becomes legally and medically incapacitated and has no PoA (spoiler alert: they most likely will become the ward of a 3rd party court-appointed legal guardian... a total stranger). Then see if she's still unwilling to assign you as PoA.
You will now have to be preemptive and creative so that you don't start having daily battles with your Mom as she gradually is robbed of her ability to use reason, logic, and judgment, and have empathy for others, loses her short-term memory, etc. You are now the only person who can change and adjust.
No one is "somewhat" independent. This just means the person is dependent. We used to tell my Aunt with dementia that company was coming, and then she's willingly take a shower. And you will also need to discuss meds for depression with your Mom's primary doc. My Mom benefited a lot from the minimum dose of Lexapro.
Taking away someone's independence doesn't have to be something that happens in a day. It can be (and should be) gradual. The caregiving arrangement must accommodate the caregiver, not the receiver. My agreement with my Mom is that she transitions into facility care either when she is no longer safe in her home or I am overwhelmed by her care. Even if she never remembers this "contract" at least I have it clear in my own mind.
I wish you all the best as you work to help your Mom.
You need to take action now.
[I wrote this last and moved to the top of this list.]
SEE A THERAPIST -
* You are grieving the loss of the mom you knew. She is changing / has changed; isn't the same person.
* Understand how difficult this is for you so be gentle with yourself - although do get the professional support you need.
* Allow your husband to support you through this process (ask him to read this). You need him to help you through these transitions. Allow him in.
If I were you:
1) I would hire a social worker and/or an elder care advocate - someone / a professional that specializes in elder care and is skilled in managing care for individuals in varying levels of dementia / losing their cognitive abilities.
There are independent medical social workers.
2) As her MD for referrals.
3) Call your local county City Hall / Senior Services Dept
4) Call Adult Protective Services - ask for a referral.
5) a) Google, read and call TEEPA SNOW. She is one of the country's leading experts on dementia and how to interact / communicate with people inflicted with dementia. Watch her webinars, buy her books.
b) Google 'how to talk to a person with mild dementia about cleaning (about bathing ...) and see what comes up. Look at You Tubes, too.
Then, you can approach her by:
1) Offering to help her 'clean up' in an assertive way. Do not 'ask her' - go to her apt and start to do something ('fun" ... let's have some fun ! ... perhaps start to put things away, get her laundry together) and in a very cheerful voice (tone of voice is REALLY important as are facial expressions), show enthusiasm to help her 'do the laundry'.
- If she is receptive / understands
* tell her that things on the floor are a possible fall risk ...
* Bathing will prevent painful (?) bed sores ... dry skin ... (whatever words work - although perhaps none will).
* I want you to be safe as I love you (positive reinforcement)
Do realize that some people w dementia fear water due to being frightened ... they may think they are going to drown ...
Do: learn how the dementia inflicted brain works 'thinks' so you can better understand/ relate / communicate.
- Expect that (as) this is new behavior on your part, and you are in her space, that she may be surprised, resist, and / or be-express confusion by your sudden desire to help / and taking this lead action.
- Consider (now) to hire a caregiver. Write down your interviewing questions. Hire through agency or independent caregiver.
Be clear on:
1) caregiver's experience and how they will communicate with her so it feels compassionate, caring, and is clear. You want someone who can take the lead in a patient, kind way.
2) Introduce this person as a 'friend' of yours.
3) Ease her into assisting your mom.
Approaching your mom_______________
Be cognizant on how you approach all these areas you mention:
- with sensitivity, patience, and pro-active behaviors.
- In other words, do not say "you aren't xxx" - "you need to ..." as this will only cause her to feel defensive and resist you/r support.
* Create a 'we are' doing ... 'we are a team' ... "I am on Team xxx (her name) so she doesn't feel alone and/or criticized.
- Remember ... she NO LONGER CAN do these things on her own. It isn't her fault. She is or will be confused, frustrated and if aware, embarrassed that she cannot function as she used to.
Expect she may resist you and look at you as 'the bad guy.' Realize this is the dementia talking, not her - as she used to be.
Take breaks as you need to. If she / you are frustrated, leave or change the subject and then come back to it ... or talk to her as you usually do and keep picking things up from the floor, take sh
You may be in denial yourself about it. I know I was. I couldn’t imagine taking away my dad’s control over finances or his driving. It was the hardest things I had to do up to that point, but Dementia keeps getting worse. If anything, people who have been through it wish they had taken the difficult steps earlier in retrospect.
If she has dementia, you (or someone) will have to start intervening and it’s not going to be fun. If she is unsafe to drive, you want to stop her before she has a tragic accident. If she’s unsafe with money, you want to stop her before she gives it all to a scam or whatever. My dad had been a very careful saver all his life and then suddenly started day trading based on stock names he thought were funny and quickly lost $50,000 of his savings. We found out he was giving large amounts of cash to a woman he felt sorry for. The opposite of his behavior and personality before!
He also went from a perfect lifetime driving record (no speeding tickets, no fender benders) to totaling one car and also driving off two hours in the wrong direction with my nephew in the car. He didn’t stop bathing or changing his clothes until a couple of years later. But he thought he was doing both and couldn’t be convinced otherwise. I don’t think he knew how anymore, but he still thought he was doing it. When he peed himself and someone pointed it out he would say he guessed something spilled on his pants. He literally could not process what had happened.
Dementia expresses itself differently in different people but there are some common patterns and what you describe is definitely one of them.
good luck and best wishes!
I would start with Teepa Snow. On YouTube.
She needs to move into Senior apts. or Asst. Living, so help her find a place. If she is "independent" she can get one. She needs to know two is company, three's a crowd. Two years in your home is enough. Does she expect you to let her stay forever? Does she pay you rent? Let her know she needs to find her own place. Stop wasting her money and get one.
I always ask people who dread this change...did your Mom take in her own Mother when she was younger and married? I doubt it.
GOOD LUCK!
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